Endotracheal Intubation
Endotracheal Intubation
NURSING
UNIVERSITY FOUNDATION
ENDOTRACHEAL INTUBATION
Endotracheal intubation a invasive procedure an insertion of flexible tube through the mouth into
the trachea beyond the vocal cords that acts as an artificial airway.
Purpose:
1. To provide patient airway.
2. To provide route for short term mechanical ventilation.
3. To facilitate removal of pulmonary secretions.
4. To relieve C02 retention in clients with COPD.
5. To treat acute respiratory failure.
Responsibilities:
1. Anesthesiologists/physician: the only person who perform the procedure.
2. ICU Nurse: assisting the doctor and recording of the procedure.
Policy:
1. Endotracheal intubation must be performed by Anesthesiologists/physician to be assisted
by a qualified nursing personnel who has adequate knowledge on the procedure.
2. A physician written order is required.
3. A written consent must be signed by the family members of the patient.
4. Sterile technique must be observed throughout the procedure.
Procedure:
1. Wash hands
2. Wear your PPE.
3. Explain step by step procedure and rationale to the patient.
4. Assemble all equipment. Ensure function of resuscitation bag with mask and suction
equipment.
5. Assess the patient vital sign and level of consciousness.
6. Remove dentures.
7. Assemble laryngoscope make sure the light bulb is tightly attached and functional.
8. Check tracheal cuff for leaking by inflating cuff.
9. Lubricate the tube.
10. Place patient in supine position with head and neck hyper-extended and pillow under the
shoulder.
11. Offer anesthetic spray, if time allows. Pre-oxygenate before the procedure.
12. Re-oxygenate if attempt fail.
13. Put mark on the tube at level of patient mouth and tape securely.
14. Inflate the cuff 5-10 cc of air after intubation is completed.
15. Insert oral airway when tube is positioned orally.
16. Assess for expansion of both sides of the chest and presence of breath sounds.
17. Record distance from proximal end of tube to the point where the tube reaches the teeth.
18. Secure tube to the patient face with tape.
19. Obtain chest xray.
20. Assess ABG if ordered.
21. Document size and type, cuff pressure and patient vital sign.